Organization Active NPI

Kizuna Counseling LLC

  • Mental Health Counselor
  • Fort Walton Beach, FL
National Provider Identifier
1679363865
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
KIZUNA COUNSELING LLC
Doing business as
Kizuna Counseling
Practice address
922 Mar Walt Dr Ste 200
Fort Walton Beach, FL 32547-6703
Phone
(850) 517-6703
Fax
(850) 204-9330
NPI assigned
May 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alina Ayako Griffin, LMHC
Title
Sole Proprietor
Phone
(850) 517-4604

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

922 Mar Walt Dr Ste 200
Fort Walton Beach, FL 32547-6703

Mailing address

922 Mar Walt Dr Ste 200
Fort Walton Beach, FL 32547-6703
Phone (850) 517-6703

Other names 1

  • Kizuna Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250602003583 FL Part B Supplier - Clinic/Group Practice 0244749125 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Walton Beach, FL

National Provider Directory

National Provider Directory

Locations

922 Mar Walt Dr
Ste 200
Fort Walton Beach, FL 32547
Phone (850) 517-4604

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1746748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1679363865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 MAR WALT DR STE 200",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476703",
            "telephone_number": "850-517-6703",
            "fax_number": "850-204-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 MAR WALT DR STE 200",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476703",
            "telephone_number": "850-517-6703",
            "fax_number": "850-204-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIZUNA COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "ALINA",
        "authorized_official_middle_name": "AYAKO",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "850-517-4604",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kizuna Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kizuna Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.